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Treatment of Clostridium difficile infection in pediatric patients

Susanna Esposito1, Giulia Umbrello, Luca Castellazzi

  • 1Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Expert Review of Gastroenterology & Hepatology
|April 28, 2015
PubMed

Insights

Clostridium difficile infections (CDIs) are uncommon in children. Mild cases resolve with antibiotic cessation or metronidazole; severe cases require vancomycin.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Clinical Therapeutics

Background:

  • Clostridium difficile causes infections ranging from asymptomatic colonization to severe disease.
  • Antibiotic overuse and misuse contribute to rising Clostridium difficile infections (CDIs).
  • Pediatric CDIs are less common due to lower susceptibility in young children to C. difficile toxins.

Purpose of the Study:

  • To discuss problems, solutions, and future perspectives for treating C. difficile infections in pediatric patients.
  • To review current and potential therapeutic strategies for pediatric CDIs.
  • To highlight the unique aspects of CDI management in children.

Main Methods:

  • Review of existing literature on C. difficile infections in pediatric populations.
  • Analysis of treatment outcomes for various therapeutic interventions.
  • Discussion of challenges and future research directions in pediatric CDI.

Main Results:

  • Most pediatric C. difficile disease is mild to moderate.
  • Discontinuation of offending antibiotics or metronidazole is effective for mild to moderate cases.
  • Vancomycin is the preferred treatment for severe or recurrent pediatric CDIs.

Conclusions:

  • Current treatment strategies are effective for most pediatric C. difficile infections.
  • Probiotics offer no significant advantages in pediatric CDI treatment.
  • Further research is needed to clarify the role of alternative treatments in severe pediatric cases.

Keywords:
Clostridium difficileantibiotic therapychildrenfecal microbiological transplantationgastrointestinal infectionprobiotics

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